Healthfirst Medicare Advantage Plans New York 2025

Looking for Healthfirst Medicare Advantage plans in New York? Understand your options with clear, concise insights into each Healthfirst Medicare advantage plan New York.

This article strips away the confusion to bring you direct information on the HMO, PPO, and HMO D SNP plans, including $0 premiums and essential benefits like drug, dental, and vision coverage.

We’ll guide you through plan specifics, from telehealth perks to wellness programs, helping you determine the best Medicare Advantage plan for your needs in New York for 2025.


Key Takeaways


  • Members benefit from telehealth services through Teladoc, 24/7 access to a Nurse Help Line, and an extensive provider network, including urgent care centers and a variety of healthcare providers.


  • Enhanced wellness support is available through programs such as SilverSneakers, the Silver&Fit program, and the Medication Therapy Management Program, along with accessible member services and community office locations for additional support.

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Healthfirst Medicare Advantage Plans Overview


Healthfirst Medicare Advantage Plans New York 2025, Healthfirst Medicare Advantage Plans Overview


As a trusted name in the healthcare industry, Healthfirst provides a variety of Medicare Advantage Plans to suit a range of needs, including the Healthfirst Medicare Plan.

With options such as HMO, PPO, and HMO D SNP plans, Healthfirst aims to deliver the best from your Medicare Advantage Plan.

With the added advantage of $0 premium options available in select areas, Healthfirst truly puts your health first, providing an additional benefit image of affordability and care.


HMO Plans

The Healthfirst Signature (HMO) plan offers comprehensive coverage, no monthly premium, a range of medical services, and care when you need it. Keep in mind that not all plans provide these benefits.


PPO Plans

The Signature (PPO) plan by Healthfirst offers:

  • Flexibility and peace of mind


  • $0 monthly premium


  • Access to any doctor or hospital in the U.S. that accepts Medicare, giving members freedom from network limitations.


It establishes an in-network maximum out-of-pocket cost of $5,000 annually and an out-of-network maximum out-of-pocket cost of $8,000 annually for covered Medicare services.


D-SNP Plans

Residents of New York City’s five boroughs and select counties can take advantage of the Healthfirst CompleteCare plan. This D-SNP plan, designed for individuals with both Medicare and full Medicaid, combines benefits from Original Medicare and Medicaid.

It also includes prescription drug coverage and other additional benefits, making it a comprehensive choice for those in need of in-home or long-term care services, such as a skilled nursing facility.


Comprehensive Benefits and Coverage


Healthfirst Medicare Advantage Plans New York 2025, Comprehensive Benefits and Coverage


The Medicare Advantage Plans by Healthfirst offer extensive benefits and coverage. They encompass everything from prescription drug coverage to dental, vision, and hearing services.

Furthermore, they include extra wellness benefits like nutrition counseling, aiming to maximize your Medicare Advantage Plan benefits.


Prescription Drug Coverage

A crucial element of Healthfirst Medicare Advantage Plans is the Medicare Advantage prescription drug coverage.

These plans offer the following benefits:

  • $0 copay for generic drugs


  • Competitive copays for other drugs


  • $250 deductible for prescriptions in Tiers 4 and 5


  • Insulin products are available at a maximum of $35 copay for a 30-day or 90-day supply without any deductible requirement.


These features simplify and make healthcare management more cost-effective.


Dental, Vision, and Hearing Services

Healthfirst ensures that your healthcare needs are met beyond just medical coverage. Dental services offer a $0 copay for preventive and comprehensive services with an annual maximum coverage of $2,500.

Vision services include a $0 copay for routine exams and a $300 allowance every two years for eyeglasses or contacts.

As for hearing services, a $0 copay for routine exams and coverage for one hearing aid per ear each year are provided.

Telehealth and Nurse Help Line Access


Healthfirst Medicare Advantage Plans New York 2025, Telehealth and Nurse Help Line Access


Membership with Healthfirst comes with the added convenience of telehealth services via Teladoc and round-the-clock access to a Nurse Help Line, guaranteeing immediate medical support whenever required.


Teladoc Telemedicine Service

Teladoc, a telemedicine service offered by Healthfirst, enables members to consult with board-certified doctors any time via phone or video for non-emergency medical issues.

This convenient service allows you to seek advice, receive a diagnosis, and get treatment recommendations right from the comfort of your home.


Nurse Help Line

The Nurse Help Line offered by Healthfirst ensures that you have around-the-clock access to medical advice and support. Whether you have a minor health issue or need advice on whether a condition requires emergency care, the Nurse Help Line is there to guide you.

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Urgent Care Centers and Provider Network


Healthfirst Medicare Advantage Plans New York 2025, Urgent Care Centers and Provider Network


Healthfirst members have access to an extensive network of urgent care centers and healthcare providers. This network ensures that you can receive medical treatment promptly when you need it.


Urgent Care Center Network

The urgent care center network provided by Healthfirst is designed to offer services for conditions that require prompt attention but are not life-threatening.

Whether it’s an earache, an upset stomach, a sprain, or a wound requiring stitches, the in-network urgent care centers are available for walk-in visits, providing treatment quickly and efficiently.


Provider Network

Healthfirst’s extensive provider network, including primary care providers (PCP), ensures that members have broad access to the care they need. The network includes a comprehensive range of healthcare services, from numerous specialists to emergency treatment by out-of-network or non-contracted providers.

SilverSneakers and Wellness Programs


Healthfirst Medicare Advantage Plans New York 2025, SilverSneakers and Wellness Programs


Healthfirst extends its focus beyond medical needs by promoting physical activity and overall well-being via SilverSneakers and other wellness programs, all purposed to guide you towards a healthier, more fulfilling life in the Sullivan community.


SilverSneakers Fitness Program

The SilverSneakers fitness program is an integral part of Healthfirst’s wellness resources.

It provides access to:

  • Fitness facilities


  • Classes


  • Workout videos


  • A mobile app


Additional Wellness Resources

In addition to SilverSneakers, Healthfirst offers the Silver&Fit wellness program. This program offers a wide array of fitness and wellness resources, from online workout videos to home fitness kits and healthy aging coaching.

Whether you prefer working out at a gym or the comfort of your home in Richmond, Healthfirst has got you covered with its orange fitness equipment.

Healthfirst Medication Therapy Management Program


Healthfirst Medicare Advantage Plans New York 2025


The Medication Therapy Management Program by Healthfirst aims to help members make the most of the plan’s prescription drug benefits. It assists patients in gaining a better understanding of their medication, thereby maximizing their prescription drug benefits.


Program Overview

The Medication Therapy Management Program offers both targeted and comprehensive medication reviews. These reviews are conducted by qualified providers to ensure optimum therapeutic outcomes and adherence to regulations.

Upon completion, members receive a personalized Medication Action Plan designed to promote the safest and most effective use of their medications.


Eligibility and Enrollment

Eligibility for the Medication Therapy Management Program includes:

  • Being diagnosed with at least three chronic diseases


  • Being prescribed at least eight covered Part D chronic medications


  • Having a projected annual Part D drug cost of $5,330 or greater.


Eligible members are automatically enrolled and can choose to opt out if desired by using the additional benefits dropdown arrow.

Support and Resources


Healthfirst Medicare Advantage Plans New York 2025, Support and Resources


Healthfirst provides an array of support services and resources to help members navigate their Medicare Advantage Plans. Detailed contact information for member services and locations of community offices are readily available to assist members when needed.


Member Services Contact Information

Healthfirst offers a 24/7 phone line for Medicare Advantage plan members to get customer support and assistance. Additionally, a virtual community office is available where members can schedule appointments for enrollment.


Community Office Locations

Healthfirst community offices are strategically located across New York, including locations in Nassau, Westchester, Main Plaza Mall, Smith Haven Mall, and Westfield South Shore Mall. Members can visit these offices for in-person assistance without needing an appointment.


In summary, Healthfirst Medicare Advantage Plans offer comprehensive coverage and numerous benefits, including $0 premium options for select plans. From prescription drug coverage to wellness programs, these plans are designed to provide complete healthcare support to members.


Frequently Asked Questions


  Does NY have Medicare Advantage plans?

Yes, New York does have Medicare Advantage plans offered by multiple private health insurance providers, including Aetna Medicare and CDPHP Medicare Advantage.

These plans are regulated by the federal government’s Centers for Medicare and Medicaid Services.


  What is the star rating for Healthfirst Medicare?

Healthfirst Medicare Advantage plans are rated four stars out of five in 2022.


  Is Healthfirst Medicaid or Medicare in NY?

Healthfirst CompleteCare plan is a Medicare Advantage Dual-Eligible Special Needs (HMO D-SNP) plan that offers both Original Medicare and Medicaid benefits in NY.


  What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plan for 2025 is offered by Humana, with 94% of its members enrolled in plans rated 4 stars and above.

This makes Humana one of the top choices for Medicare Advantage coverage.


 What types of plans does Healthfirst offer?

Healthfirst offers HMO, PPO, and D-SNP Medicare Advantage plans in New York, providing a range of options for different healthcare needs.

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Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.